Targeting Skin Barrier Function in Atopic Dermatitis

Bogaard, Ellen H. van den; Elias, Peter M.; Goleva, Elena; Berdyshev, Evgeny; Smits, Jos P.H.; Danby, Simon; Cork, Michael J.; Leung, Donald Y.M.

doi:10.1016/j.jaip.2023.02.005

Cited by 29 publications

(8 citation statements)

References 110 publications

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“…Skin barrier dysfunction is characteristic finding of AD, substantially contributing to its progression and the manifestation of pruritic symptoms ( Kim and Leung, 2018 ; Leung et al, 2020 ; van den Bogaard et al, 2023 ). Therefore, to understand the mechanisms underlying the positive effects of advanced FOS on AD symptoms, we investigated whether advanced FOS modulates the expression of ELOVL s and epidermal barrier proteins, which are associated with skin barrier function ( Kim and Leung, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Advanced fructo-oligosaccharides improve itching and aberrant epidermal lipid composition in children with atopic dermatitis

Kim,

Kang,

et al. 2024

Front. Microbiol.

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IntroductionThe effects of fructo-oligosaccharides (FOS) on atopic dermatitis (AD) have not been determined.MethodsIn a randomized, double-blind, placebo-controlled trial, children with AD aged 24 months to 17 years received either advanced FOS containing 4.25 g of 1-kestose or a placebo (maltose) for 12 weeks.ResultsThe SCORAD and itching scores were reduced in patients treated with both FOS (all p < 0.01) and maltose (p < 0.05 and p < 0.01). Sleep disturbance was improved only in the FOS group (p < 0.01). The FOS group revealed a decreased proportion of linoleic acid (18:2) esterified omega-hydroxy-ceramides (EOS-CERs) with amide-linked shorter chain fatty acids (C28 and C30, all p < 0.05), along with an increased proportion of EOS-CERs with longer chain fatty acids (C32, p < 0.01).DiscussionFOS may be beneficial in alleviating itching and sleep disturbance, as well as improving skin barrier function in children with AD.

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Section: Discussionmentioning

confidence: 99%

Advanced fructo-oligosaccharides improve itching and aberrant epidermal lipid composition in children with atopic dermatitis

Kim,

Kang,

et al. 2024

Front. Microbiol.

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“…Earlier findings indicate a reduced chain length of FFA and ceramides in atopic skin (nLAS vs. HS and LAS vs. nLAS) [33,80,81], especially the very-long-chain FFA [47,82], which causes decreased formation of the orthorhombic lateral organisation in favour of the less dense hexagonal organisation [33,83,84]. Higher levels of inflammatory cytokines (such as IFN-α) are potential factors causing this reduction in the chain length by decreasing the two elongases of fatty acids ELOVL 1 and ELOVL4 [4,80] and higher IL-4/13 levels inhibiting ELOVL3 and ELOVL6 [40]. Apart from chain length, the level of saturation in FFA also influences the lateral ICL organisation [85], with corresponding differences being observed among LAS, nLAS, and HS regarding the concentration of unsaturated FFA and the activity of the corresponding processing enzymes [80].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it is not surprising that reduced or even total loss of filaggrin in AD is associated with lower NMF concentration, higher TEWL, skin xerosis [4,37], and higher Staphylococcus aureus colonisation [29]. While genetic filaggrin mutations are not found in all AD patients [38][39][40], inflammatory cytokines such as IL-4/13 are also able to reduce filaggrin expression. Other described factors responsible for the impaired atopic SBF are dysfunctional tight junctions [41], reduced antimicrobial peptides [4], and a disturbed milieu of commensal microbiome [42][43][44], e.g., with reduced presence of physiologically appearing Cutibacterium, Streptococcus, Corynebacterium, and Proteobacteria, in favour of Staphylococcus colonisation [45] which correlates with higher TEWL [46].…”

Section: Introductionmentioning

confidence: 99%

Atopic Dermatitis: Molecular Alterations between Lesional and Non-Lesional Skin Determined Noninvasively by In Vivo Confocal Raman Microspectroscopy

Zolotas,

Schleusener,

Lademann

et al. 2023

IJMS

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Atopic dermatitis (AD)/atopic eczema is a chronic relapsing inflammatory skin disease affecting nearly 14% of the adult population. An important pathogenetic pillar in AD is the disrupted skin barrier function (SBF). The atopic stratum corneum (SC) has been examined using several methods, including Raman microspectroscopy, yet so far, there is no depth-dependent analysis over the entire SC thickness. Therefore, we recruited 21 AD patients (9 female, 12 male) and compared the lesional (LAS) with non-lesional atopic skin (nLAS) in vivo with confocal Raman microspectroscopy. Our results demonstrated decreased total intercellular lipid and carotenoid concentrations, as well as a shift towards decreased orthorhombic lateral lipid organisation in LAS. Further, we observed a lower concentration of natural moisturising factor (NMF) and a trend towards increased strongly bound and decreased weakly bound water in LAS. Finally, LAS showed an altered secondary and tertiary keratin structure, demonstrating a more folded keratin state than nLAS. The obtained results are discussed in comparison with healthy skin and yield detailed insights into the atopic SC structure. LAS clearly shows molecular alterations at certain SC depths compared with nLAS which imply a reduced SBF. A thorough understanding of these alterations provides useful information on the aetiology of AD and for the development/control of targeted topical therapies.

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“…Although parents may desire to identify underlying causes to AD, there is typically no underlying etiology identified for AD in an individual child. Even prior to visible manifestation of AD, sampling of the skin microbiome by noninvasive self-adhesive skin tape strips identified indicators of more severe AD, including colonization with Staphylococcus aureus (SA), higher levels of interleukin (IL)-13 and thymic stromal lymphopoietin (TSLP) in the epidermis at two months of age, increased transepidermal water loss at three months of age, and increased levels of the chemokine, CCL17, two months prior to the appearance of AD [2 ▪▪ ,3 ▪ ,4].…”

Section: Risk Factors For Atopic Dermatitismentioning

confidence: 99%

A practical approach to caring for atopic dermatitis in children

Bayer

2023

Current Opinion in Pediatrics

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Purpose of review Atopic dermatitis is a chronic, systemic disease with primary cutaneous clinical manifestations and is commonly attributed to an exaggerated Th2 inflammatory response. Recent research regarding risk factors, prevention, clinical features, and management of atopic dermatitis will be reviewed. Recent findings In the last decade, advances have been made in identifying the factors that either confer increased risk for or protection from atopic dermatitis and associated atopy. Progress has also been made in the clinical management of this disease. Promising biomarkers and therapeutically informative characteristics of this disease have been identified in young children with and without the presence of eczema, but much has yet to be elucidated. Progress has also been made in clarifying the advantages and disadvantages of respective medical managements, including but not limited to topical corticosteroids, topical calcineurin inhibitors, phototherapy, systemic immunosuppressants, and targeted immunotherapy. Given that medical management may show variable efficacy in a child, an optimized skin care regimen is of utmost importance as well. Summary Atopic dermatitis is a challenging, chronic systemic disease that incurs significant morbidity in affected children. Although management options have been somewhat disappointing in years past, promising results have been observed in recent advances in targeted immunotherapy.

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Targeting Skin Barrier Function in Atopic Dermatitis

Cited by 29 publications

References 110 publications

Advanced fructo-oligosaccharides improve itching and aberrant epidermal lipid composition in children with atopic dermatitis

Advanced fructo-oligosaccharides improve itching and aberrant epidermal lipid composition in children with atopic dermatitis

Atopic Dermatitis: Molecular Alterations between Lesional and Non-Lesional Skin Determined Noninvasively by In Vivo Confocal Raman Microspectroscopy

A practical approach to caring for atopic dermatitis in children

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